Swimmer alert: Danger may lurk in those contacts

Swimming in chilly Lake Michigan usually is the most nerve-racking part of Sunday's Accenture Chicago Triathlon, one of the largest swim-bike-run competitions in the world.

The course along the Monroe Harbor seawall is narrow, choppy and congested. Potential hazards include getting smacked in the head by overenthusiastic competitors or swallowing a wave, when what you really need is air.

An often-overlooked danger of the swim, though, comes from a source most people would never suspect: contact lenses. It might sound like an urban myth, but eye specialists say that wearing soft or rigid gas-permeable contacts in lakes or pools can lead to serious infection and even blindness.

I've been swimming with my gas-permeable lenses (and goggles) for 10 years and regularly visiting an eye doctor for 30. I've never been warned about this, and my vision is so bad that, for the safety of others, I wouldn't dream of swimming lens-free.

But now that I've heard about 16-year-old Jackie Stillmaker's torturous battle with Acanthamoeba keratitis, a rare but painful infection of the cornea, Lasik eye surgery is looking more attractive.

Stillmaker of Des Plaines was an incoming freshman at Maine West High School when she swam in both a lake and a wave pool while wearing soft contact lenses and developed an eye infection. Her doctor diagnosed pink eye, but she wasn't responding to the medication. Weeks later the teen woke up in excruciating pain, with white circles around her cornea.

The culprit was a microscopic, water-borne parasite named Acanthamoeba. This creature, which especially loves the spongy plastic of soft lenses (but also adheres itself to gas permeable) is found everywhere; in the soil and dust and in water sources such as lakes, rivers, hot tubs, chlorinated swimming pools, tap water and even bottled water.

Once the protozoan gets into the eye, the lens holds it there. Acanthamoeba can then invade the cornea, causing an infection or corneal ulcer. Symptoms include feeling as if there's something in your eye, watery eyes, blurred vision, sensitivity to light, swelling of the upper eyelid and extreme pain. If detected early, when only the surface layer of the cornea is infected, it may respond rapidly to treatment. If the parasite takes up residence, it can take a year or longer to remedy.

For every million lens wearers, just two or three people normally contract Acanthamoeba each year. But in the Chicago area, 35 cases were reported between May 2003 and May 2005, an unusually high number. "It's recently resurfacing because people are swimming with contacts," said Randy Epstein, Stillmaker's doctor and a professor of ophthalmology at Rush University Medical Center. "Almost all other infections can be readily treated. When people get this one, it can be really devastating."

Since 2002, Stillmaker has had three corneal transplants and massive doses of toxic medication to kill the resilient bug. She still needs another transplant to have a cataract removed.

Her mother, Mary Beth, is lobbying the Food and Drug Administration to place warnings on contact lens products detailing the dangers of swimming with contacts.

Epstein is adamant that all swimmers, including the Chicago triathlon participants who need eyewear, should go without lenses. "Leave your contacts and solution at your bike and follow the other swimmers," he said.

You could also wear prescription goggles or have someone try to hand you your glasses at the end of the swim. (They must stand behind the fence lining the course.)

Still, triathletes know these aren't very practical solutions. Some of us would never find our bike or the blurry figure holding our glasses. Meanwhile, it's hard enough to get feet into bike shoes after a swim. Are you really going to try to insert a contact lens in the middle of the race?

If you take the risk, eye doctors say with a cringe, consider swimming with a daily disposable lens. That way you can immediately throw them away afterward and start with a fresh pair. Gas-permeable wearers--about 15 percent of lens users--should consider the lenses contaminated and disinfect them after a swim. Never sleep in lenses, especially after swimming.

And always remember where you've tossed your protective eyewear. Chicago triathlete Craig Patnode once whipped off his goggles with such force that one of his gas-permeable contacts popped out. He later found the missing lens still stuck inside his goggles.